Harvard is looking for a few good nurses. Well, more than a few - 100,000 to be exact.
Why do they want you? Because nurses, with their clinical knowledge, can answer personal health questions with a great deal of accuracy!
Researchers from Boston's Harvard School of Public Health and Brigham and Women's Hospital are launching Nurses' Health Study 3 (NHS3) and are seeking female RNs, LPNs and nursing students between the ages of 26 and 40 who live in the U.S. or Canada.
They are especially hopeful minority nurses will sign up for this open-ended study that will be entirely web-based, meaning all communication with participants will be done electronically through questionnaires, etc.
If you participate you'll be in great company.
You'll join the almost 240,000 nurses who, since 1976, have participated in Nurses' Health Study 1 (NHS1, www.channing.harvard.edu/nhs and Nurses' Health Study 2 (NHS2) - two studies that are still ongoing.
Why are these NHS participants exalted company?
That's easy to answer because the information provided by these nurses led to so many advances in healthcare and informed many perceptions about diseases.
For example, changes were made in the late 1970s in the formulation for oral contraceptives when research, specifically gleaned from data from the NHS1, revealed a link between birth control pills and breast cancer.
Information on the development and progression of Alzheimer's disease was boosted by NHS1, as was research that led to listing trans fats on food labels. Data from NHS1 and NHS2 were used to create the current classification of body mass index (BMI).
NHS1 began in 1976, drawing 122,000 married RNs aged 30-55 who lived in the 11 most populated states at that time - California, Connecticut, Florida, Maryland, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania and Texas. It intended to examine the long-term consequences of using oral contraceptives, but also looked at diseases and health-related topics such as smoking, hormone use and menopausal status.
NHS 2 began in 1989, also with funding from the NIH, and recruited 116,686 nurses between ages 25 and 42 from California, Connecticut, Indiana, Iowa, Kentucky, Massachusetts, Michigan, Missouri, New York, North Carolina, Ohio, Pennsylvania, South Carolina and Texas. It too intended to research oral contraceptives, but also examined and is still studying, diet and lifestyle risk factors in a population younger than NHS1.
"It's a great success story to be able to increase knowledge of women's health and the general population," said Jorge Chavarro, MD, ScD, assistant professor of nutrition and epidemiology at Harvard School of Public Health and a researcher in NHS3.
Chavarro's area of study is fertility, pregnancy complications and pregnancy outcomes and he is hoping NHS3 will offer some answers in this arena.
"NHS1 and 2 contributed to our knowledge of cardiovascular disease, cancer, breast cancer, diabetes," he said. "We don't know what we'll discover from NHS3."
Chavarro may not know what the outcomes of NHS3 will be, but based on the enthusiasm of one volunteer who signed on, he can be assured subjects will be dedicated. Christy Hovestol Bryant, BSN, RN, 27, who has one daughter with another one on the way, grew up with the Nurses' Health Study in more ways than one.
"My mother participates in [NHS]2," said Bryant, who has been a nurse for 5 years.
"She would proudly point out news stories to us children about research produced as a result of NHS2 and tell us 'I contributed to that'. "She is so proud of her participation and is still part of the study. I remember her having to provide urine and blood specimens for the study and doing it gladly."
Her mom, Carey Hovestol, BSN, RN, encouraged three of her five children, who were eligible because of their ages, to participate in another ongoing NHS2 study of children.
Called GUTS (Growing Up Today Study), the study which recruited children ages 9-14 in 1996 and 2004, examines factors that influence weight change. "Me and two of my siblings were part of GUTS," Bryant shared.
So when Bryant heard about a new NHS study from her mom, she joined right away in 2010.
"It's very easy to sign up online at www.nhs3.org," she noted. "So far I have filled out four questionnaires, one general one pertaining to the study and three pertaining to pregnancy."
Bryant said the questionnaires are easy to answer and don't take long, asking "simple diet and lifestyle questions. Everything is done online so it's very easy to participate. When they have a new questionnaire, they e-mail it to you."
Making it Easy
According to Chavarro, who is also assistant professor of medicine at Harvard Medical School, a great deal of thought went into these questionnaires, seeking simplicity and clarity. The questionnaire can automatically divide into sub-topics for practical reasons. For example, if a nurse is asked: are you pregnant or trying to get pregnant and answers "no," the survey automatically skips a whole page of questions pertaining to pregnancy.
"You may not be able to ask the general population about different sub-types of cardiac disease but you can ask for specificities from nurses," said Chavarro, who was not born yet when NHS1 started.
The long-term goal of NHS3 is to "generate resources to look at a large number of issues in nursing, Chavarro explained, so questions will delve into:
• occupational exposure to administering chemotherapy/antineoplastic agents;
• occupational exposure to antivirals and antibiotics;
• exposure to radiation isotopes, implants etc., looking at long-term consequences of chronic exposure;
• exposure to disinfectants, especially for operating room nurses;
• reproductive and mental health;
• consequences of heavy lifting;
• exposure to anesthetics, especially among nurse anesthetists; and
• fertility and pregnancy complications and pregnancy outcomes.
Casting a Wide Net
Besides exposure and disease issues, Chavarro said NHS3 researchers are hoping to recruit a wider cohort of minority nurses.
"In [NHS]1 and 2 participants were mostly white women," Chavarro explained. "Only about 5 percent of participants in those cohorts were minority, which was the racial distribution of nurses when those studies began. But that's not how nursing looks today."
NHS3 has elicited the help of several organizations, including the National Black Nurses Association, to recruit a strong minority cohort.
Millicent Gorham, PhD(hon), MBA, FAAN, executive director of the National Black Nurses Association headquartered in Silver Spring, MD, said her organization has been working with NHS3 for 3 years now.
"To outline the importance of getting involved in this study we put articles in our quarterly newsletter, on our Facebook page, contacted deans and faculty at HBCUs [historically black colleges and universities] and sent information to our 3,000 members."
To date 16 percent of the 30,000 nurses who have signed up are from a minority group.
A short conversation with Hovestol, who joined NHS2 in 1989, would be all it takes to convince a person to sign on to NHS3.
"I'm recruiting people at work," she told ADVANCE. "I'm an infusion nurse in chemotherapy but I also posted notices in our break room to let nurses know throughout the hospital about this opportunity because I believe in it. I've even talked some nursing students into participating. It's something proactive we can do as nurses.
"When I signed up for Nurses 2, I didn't understand the full scope of the project," Hovestol continued. "Now I know it's important and unto death do we part. My doctor's have releases for my medical information to go to [NHS]2 when I die. To me it's a prize to be a part of this and it's very special to have my daughter participate."
Bryant was equally eloquent: "I think as a nurse, a daughter, granddaughter, sister, mother, I can contribute to the health of future generations by being in [NHS]3. It's a gift and an easy time commitment."
Gail O. Guterl is a frequent contributor to ADVANCE.